A study presented during the 2021 ASCO Annual Meeting found that the growth rate and site of pulmonary metastasis may play a role in predicting lung relapse and overall survival (OS) in patients with bone and soft tissue sarcomas (B-STS).
They retrospectively assessed patients who underwent surgery for B-STS pulmonary progression between 2005 and 2019 at three centers. Their focus was on the site of relapse (into the parenchyma or near the pleura) and the lung metastasis growth rate, defined as tumor doubling time (TDT).
Final analysis included 138 patients who underwent lung metastasectomy, with a median age at the time of surgery of 50 years. Median progression-free survival (PFS) was 8.7 months, lung-PFS was 8.6 months, and OS was 40.6 months. In univariate analysis, factors associated with lung-PFS and OS were Eastern Cooperative Oncology Group (ECOG) 0, nodule number <3, being disease-free after first-line treatment, no pleural involvement, and TDT >40 days. Correlations were also observed between a disease-free interval of at least 24 months and lung-PFS, and absence of metastases at diagnosis and OS.
In multivariate analyses, factors that remained associated with lung-PFS were TDT >40 days, nodule number <3, and no pleural involvement. For OS, factors were the same, and also included ECOG 0.
“Acknowledging its retrospective nature and the need for an external validation, our series highlights the key-role of the anatomical site of relapse within the lung and the impact of tumor growth rate. If confirmed, these two clinical parameters should be factored in the decision making on performing pulmonary metastasectomy,” the researchers concluded.